A systematic review of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in young children (aged 0–5 years)

Abstract

Background Accurate proxy-report questionnaires, adapted to the child’s developmental stage, are required to monitor 24-h movement behaviors in young children, especially for large samples and low-resource settings. Objectives This review aimed to summarize available studies evaluating measurement properties of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in children aged 0–5 years. Methods Systematic literature searches were carried out in the PubMed, Embase and SPORTDiscus databases, up to January 2021. For physical activity and sedentary behavior questionnaires this is a review update, whereas for sleep questionnaires we included all relevant studies published up to now. Studies had to evaluate at least one of the measurement properties of a proxy-report questionnaire assessing at least duration and/or frequency of physical activity, sedentary behavior and/or sleep in 0- to 5-year-old children. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to evaluate the quality of evidence. Results Thirty-three studies were included, examining a total of 37 questionnaires. Ten questionnaires were designed for infants, two for toddlers, 11 for preschoolers, and 14 for a broader age range targeting multiple of these age groups. Twenty questionnaires assessed constructs of sleep, four assessed constructs of physical activity, two assessed screen behavior, five assessed constructs of both physical activity and sedentary behavior, and six assessed constructs of all 24-h movement behaviors. Content validity was evaluated for six questionnaires, structural validity for two, internal consistency for three, test-retest reliability for 16, measurement error for one, criterion validity for one, and construct validity for 26 questionnaires. None of the questionnaires were considered sufficiently valid and/or reliable for assessing one or more movement behaviors in 0- to 5-year-old children, and the quality of evidence was mostly low or very low. Conclusions Valid and/or reliable questionnaires assessing 24-h movement behaviors in 0- to 5-year-olds are lacking. High-quality studies are therefore required, to develop proxy-report questionnaires and evaluate their measurement properties. PROSPERO registration number CRD42020169268.

Happy Family, Healthy Kids

“…Interestingly, the program's effects on increasing F/V intake were larger and more consistent in Year 2 when using skin carotenoids (d = 0.16-0.55) rather than proxy/self-reported measures (d = −0.22 to 0.46) to assess dietary intake. As indicated in previous literature, proxy-reported measures are not reliable or valid for assessing young children's lifestyle behaviors (Arts et al, 2022). In addition, food consumption records, 24-hour dietary recall, and food frequency questionnaires have limitations regarding recall bias, interviewer bias, high respondent burden, high cost, significant time commitment, and low accuracy (Shim et al, 2014).…”

Correlates of Physical Activity in 0- to 5-year-olds: A Systematic Umbrella Review and Consultation of International Researchers

“…Last, the lack of appropriate measurement instruments makes it even more difficult to assess PA in young children. Available measurement instruments, both direct (e.g., accelerometer) and indirect (e.g., questionnaire), all have substantial limitations and generally have unknown or insufficient validity and reliability in this age group [61][62][63]. Although accelerometry is widely considered the most promising method for PA assessment, validated methods in children up to the age of 3 years are currently lacking [62].…”

Methods recently used for the assessment of physical activity in children and adolescents

“…Despite the great variety of questionnaires to assess PA in children [21 ▪▪ ,37 ▪ ,38,39], not all of them are validated for certain populations. In addition, each questionnaire can be designed to assess different patterns of physical activity.…”